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9 April 2013

It takes three to make this child

A new technique called “mitochondrial replacement” is about to be presented to ministers as a solution to a particularly thorny reproductive dilemma.

By Michael Brooks

On 25 March, the Science Museum announced the winners of the Great British Innovation Vote. The Human Fertilisation and Embryology Authority (HFEA) didn’t win, largely because it wasn’t on the ballot. The closest available nominee in the “past innovations” category was in vitro fertilisation, which came in at 44th place (Alan Turing’s “universal machine” won). IVF led directly to the creation of the HFEA; thanks to this, Britain now leads the world in the sensible analysis, discussion and regulation of reproductive technology.

A new technique called “mitochondrial replacement” is about to be presented to ministers as a solution to a particularly thorny reproductive dilemma. Should parliament approve its use, mitochondrial replacement will give a workaround to the small number of couples who fear having a child because they carry genes that might give their offspring a severe and incurable disease.

The HFEA has carried out a long consultation on the ethical implications of this technology. It investigated the implications and canvassed public opinion and discovered “broad support” for the technique. However, as with IVF, there are those who don’t want it to go ahead.

There are two main objections. The first is that the technique could cause emotional harm to children born through mitochondrial replacement, because they will carry the DNA of three adults, rather than the usual two.

The extra adult is a donor of mitochondria, which are the energy generators that sit inside each cell. Though they are not part of the nucleus, which carries upwards of 20,000 genes, the mitochondria do carry a few dozen genes that get passed on to the next generation. If these are damaged, they can cause the onset of disease and the potential for disease is passed on through the generations.

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Replacing damaged mitochondrial DNA with healthy mitochondrial DNA from a donor evades this risk. The objection is: what if the donor wants to be a parent, too? Or what if the donor wants anonymity but the child wants to know the person from whom he or she inherited some DNA?

The second big objection is that deliberately altering DNA is a step too far. If we do this, objectors say, what is to stop us trying to create better-looking or more intelligent children?

Both points are worth raising. We don’t know what will happen with parenthood issues but the number of problem cases will almost certainly be tiny. As for the “designer baby” argument, we are nowhere near being able to do this. Yet we are at the point where we can help a few would-be parents fearful of reproducing because of the legacy they may impose on their child. What’s more, the HFEA’s recommendation is that every case should be examined on its own merits. There are no floodgates opening here.

The Department of Health and then parliament still have to approve mitochondrial replacement before it is licensed. Nonetheless, this is a great British moment. No other country in the world has the infrastructure to get it to this point. A near-miraculous combination of factors is responsible: compassion and empathy for those in heartbreaking circumstances; public trust in science; brilliant, creative scientists who want to stay in line with their society’s wishes; intelligent public discourse and (largely) responsible reporting in the media. And, indeed, the Great British HFEA. We should all be proud.

Michael Brooks’s “The Secret Anarchy of Science” is published by Profile Books (£8.99)

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